title: Playing with curricular milestones in the educational sandbox: Q-sort results from an internal medicine educational collaborative.
abstract: OBJECTIVE
  In competency-based medical education, the focus of assessment is on learner demonstration of predefined outcomes or competencies. One strategy being used in internal medicine (IM) is applying curricular milestones to assessment and reporting milestones to competence determination. The authors report a practical method for identifying sets of curricular milestones for assessment of a landmark, or a point where a resident can be entrusted with increased responsibility.
  
  
  METHODS
  Thirteen IM residency programs joined in an educational collaborative to apply curricular milestones to training. The authors developed a game using Q-sort methodology to identify high-priority milestones for the landmark "Ready for indirect supervision in essential ambulatory care" (EsAMB). During May to December 2010, the programs'ambulatory faculty participated in the Q-sort game to prioritize 22 milestones for EsAMB. The authors analyzed the data to identify the top 8 milestones.
  
  
  RESULTS
  In total, 149 faculty units (1-4 faculty each) participated. There was strong agreement on the top eight milestones; six had more than 92% agreement across programs, and five had 75% agreement across all faculty units. During the Q-sort game, faculty engaged in dynamic discussion about milestones and expressed interest in applying the game to other milestones and educational settings.
  
  
  CONCLUSIONS
  The Q-sort game enabled diverse programs to prioritize curricular milestones with interprogram and interparticipant consistency. A Q-sort exercise is an engaging and playful way to address milestones in medical education and may provide a practical first step toward using milestones in the real-world educational setting.
authors.affiliation: Department of Medicine, Tufts University School of Medicine, Springfield, MA 01199, USA. Lauren.meade@bhs.org
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Meade
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Caverzagie
authors.forename: Susan R
authors.initials: SR
authors.lastname: Swing
authors.forename: Ron R
authors.initials: RR
authors.lastname: Jones
authors.forename: Cheryl W
authors.initials: CW
authors.lastname: O'Malley
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Aimee K
authors.initials: AK
authors.lastname: Zaas
mesh_terms: D000328:Adult; D003162:Competency-Based Education / Q000379:methods*; D003299:Cooperative Behavior; D004521:Educational Measurement / Q000379:methods; D005180:Faculty, Medical; D005260:Female; D005717:Games, Experimental; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D017009:Professional Autonomy; D011361:Professional Competence / Q000592:standards; D011779:Q-Sort; D014481:United States